Topical antifungals usually effective for treatment of tinea corporis and tinea cruris.78910143237 An oral antifungal may be necessary if tinea corporis or tinea cruris is extensive, dermatophyte folliculitis is present, the infection is chronic or does not respond to topical therapy, or patient is immunocompromised because of coexisting disease or concomitant therapy.789141532

Topical antifungals usually effective for treatment of uncomplicated tinea pedis.78910143237 An oral antifungal usually necessary if tinea pedis is extensive, the infection is chronic or does not respond to topical therapy, patient is immunocompromised because of coexisting disease or concomitant therapy, or the infection involves hyperkeratotic areas on soles or chronic moccasin-type (dry-type) tinea pedis.78910143237

Pityriasis Versicolor

Has been used for treatment of pityriasis versicolor (also known as tinea versicolor) caused by Malassezia furfur (Pityrosporum ovale).14193031

Terbinafine Hydrochloride Dosage and Administration

Administration

Topical Administration

Do not administer intravaginally;20212223 do not apply in or near the mouth or eyes.20212223

Wash affected area with soap and water and dry completely prior to application.20212223 Wash hands after each application.20212223

When using the cream, gently rub into affected areas and surrounding skin.2

When using the spray solution, hold container 4–6 inches from the skin and spray a thin layer of solution over affected areas.22 Do not use the solution spray on the face.19

Do not use with occlusive dressings or wrappings, unless otherwise directed by clinician.119

Do not use for self-medication in children <12 years of age without consulting a clinician.20212223

Dosage

Available as terbinafine hydrochloride202122 or the base;23 dosage expressed in terms of terbinafine.1

Pediatric Patients

Dermatophytoses

Tinea Corporis or Tinea Cruris

Topical

For self-medication in children ≥12 years of age (1% cream, 1% spray solution, 1% gel): Apply once daily (morning or night) for 1 week or as directed by clinician.20212223 Use amount sufficient to cover affected areas and surrounding skin.20212223

Tinea Pedis

Topical

For self-medication of interdigital infections between toes in children ≥12 years of age (1% cream, 1% spray solution): Apply twice daily (morning and night) for 1 week or as directed by clinician.2022 Alternatively, apply 1% gel once daily (at bedtime) for 1 week or as directed by clinician.23 Use amount sufficient to cover affected areas between toes.20212223

For self-medication of tinea pedis involving bottom or sides of foot in children ≥12 years of age (1% cream): Apply twice daily (morning and night) for 2 weeks or as directed by a clinician.20 Use amount sufficient to cover all affected areas.20

Adults

Dermatophytoses

Tinea Corporis or Tinea Cruris

Topical

For self-medication (1% cream, 1% spray solution, 1% gel): Apply once daily (morning or night) for 1 week or as directed by clinician.202122 Use amount sufficient to cover affected areas and surrounding skin.202122

Tinea Pedis

Topical

For self-medication of interdigital infections between toes (1% cream, 1% spray solution): Apply twice daily (morning and night) for 1 week or as directed by clinician.2022 Alternatively, apply 1% gel once daily (at bedtime) for 1 week or as directed by clinician.23 Use amount sufficient to cover affected areas between toes.20212223

For self-medication of tinea pedis involving bottom or sides of foot (1% cream): Apply twice daily (morning and night) for 2 weeks or as directed by a clinician.20 Use amount sufficient to cover all affected areas.20

Pityriasis Versicolor

Topical

Cautions for Terbinafine Hydrochloride

Contraindications

Hypersensitivity to terbinafine or any ingredient in the formulation.119

Warnings/Precautions

Sensitivity Reactions

If irritation or sensitivity occurs, discontinue the drug and initiate appropriate therapy.11920212223

General Precautions

Selection and Use of Antifungals

Prior to initiation of treatment of dermatophytoses, diagnosis can be confirmed by direct microscopic examination of scrapings from infected tissue mounted in potassium hydroxide (KOH) or by culture using an appropriate medium.179141932

Prior to initiation of treatment for pityriasis versicolor, confirm diagnosis by direct microscopic examination of scrapings from infected tissue mounted in KOH.119

Clinical improvement usually evident within the first week of topical treatment, and patients treated for 1–2 weeks usually show continued improvement for several weeks after completion of treatment.12468111418 If clinical improvement not evident within 2–6 weeks after completion of topical treatment, reevaluate diagnosis.1

Stability

Storage

Topical

Cream

Gel

Solution

Actions and Spectrum

May be fungicidal or fungistatic in action, depending on concentration of the drug and specific fungus tested.1234111519

Appears to interfere with sterol biosynthesis in susceptible fungi by inhibiting the enzyme squalene monooxygenase (squalene 2,3-epoxidase).1219 The resulting accumulation of squalene (the usual substrate of the enzyme) in the cells and decreased amounts of sterols, especially ergosterol,1219 may contribute to the antifungal effects.2

Spectrum of activity includes dermatophytes, yeasts, and some other fungi.12

Other fungi: Active in vitro against Malassezia furfur.13 Also active in vitro against some Candida, including C. albicans and C. parapsilosis.234111315 Less active than azole antifungals against Candida.22628

Advice to Patients

Importance of using topical preparations containing terbinafine as directed;11920212223 importance of completing full course of treatment, even if symptoms improve.11920212223

The cream, solution, and gel are for external use only;20212223 importance of avoiding contact with vagina, mouth, and eyes.20212223 If accidental contact with eyes occurs, importance of rinsing eyes thoroughly with water and consulting a clinician if symptoms persist.1920212223

Importance of washing the affected areas with soap and water and drying completely before applying topical terbinafine;20212223 importance of washing hands after application.20212223

For patients with tinea pedis (athlete's foot, ringworm of the foot), importance of wearing well-fitting, ventilated shoes and changing shoes and socks at least once daily.202223

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Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include IBM Watson Micromedex (updated 1 May 2019), Cerner Multum™ (updated 2 May 2019), Wolters Kluwer™ (updated 1 May 2019) and others.